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Query: UMLS:C0017160 (gastroenteritis)
 11,398 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During two years, 1,217 children hospitalized with gastroenteritis at the Children's Centre in Winnipeg, Manitoba, Canada were studied. Bacterial pathogens were present in 25% of these children: enteropathogenic Escherichia coli in 120, Shigella in 139, Salmonella in 24, and multiple pathogens in 18. Rotavirus was detected in 54 (11%) of 472 patients examined. Rotavirus and enteropathogenic E. coli were the most common pathogens in infants, and Shigella was the most common in older children. Bacterial diarrhea occurred more commonly in summer, whereas rotavirus infection occurred more commonly in winter. Among 276 children screened, enterotoxigenic E. coli was found in three, and Aeromonas shigelloides that produced a similar toxin in two others. Enteroinvasive E. coli was not detected in 70 children. Organisms producing toxins "cytotoxic" to HeLa cells were isolated from three of 90 children. Screening for enterotoxigenic or enteroinvasive organisms was not productive of a significant number of pathogens, and, although screening for rotavirus did improve the number of etiologic diagnoses, the etiology of the majority of cases of diarrhea remained unknown.
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PMID:Gastroenteritis in children: a two-year review in Manitoba. I. Etiology. 33 Jul 69

Techniques used in the research laboratory for the microbiological diagnosis of infantile gastroenteritis are described. These techniques are in essence experimental models of the three pathogenetic mechanisms of bacterial diarrhoea. From the clinical bacteriological standpoint, although there is little difficulty with the identification of enteropathic bacteria such as Salmonella and Shigella, the differentiation of enteropathic strains of Escherichia coli from commensal strains is not possible with present routine bacteriological procedures. Possible adaptations of these experimental techniques to the routine laboratory are discussed. At present, negative-staining electron microscopy is the only way in which reoviruslike particles, the most important viral pathogen in infantile gastroenteritis, may be detected. Because of its relative simplicity this examination is strongly recommended in all cases of infantile gastroenteritis.
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PMID:Experimental techniques in the determination of aetiology of acute infantile gastroenteritis. 79 Jun 2

Acute gastroenteritis is the commonest gastrointestinal disorder in children. It accounted for about 10% of the admissions to a general paediatric unit in Singapore. About 5% of total paediatric admissions to all the government hospitals in Singapore were due to acute gastroenteritis. Some 50% of the cases had no identifiable organism in the stools. Most of the remaining cases were due to bacterial or viral infections. The commonest bacteria responsible for acute gastroenteritis nowadays is Salmonella species. Other bacteria such as E. coli, Shigella and Campylobacter were responsible for a smaller proportion of bacterial diarrhoea in children. Rotavirus was the commonest viral agent responsible for acute diarrhoea among Singapore children. Most patients had mild diarrhoea and severe dehydration following acute gastroenteritis was not common. About 60% of the patients admitted to hospital were younger than two years of age. Bacterial infections were more common in infancy. Viral diarrhoea were more likely to be watery and bacterial diarrhoea were more likely to be bloody and mucoid. With regard to chronicity, it was the groups with mixed infection or bacteria infection which had a prolonged course. Treatment was directed at maintaining hydration and prevention of complications. Except for secondary lactase deficiency, other long term complications were rare.
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PMID:Gastrointestinal infections in Singapore children. 188 88

We report a prospective study of the cases of acute diarrhea admitted to our pediatric service during one year (n = 172) to elaborate a screening method to identify patients with bacterial diarrhea. A bacterial causative organism was identified in 31.4%. The most common species was Salmonella, followed by Campylobacter. We evaluated the clinical presentation parameters, looking for differences between the group were a bacterial organism was isolated and in the group where it was not. We designated a score valid as a first level screening for bacterial diarrhea. With a score greater than or equal to 7 the sensitivity was 81.5% and the specificity 60.2%. The latter increased to 95% when occult blood in feces was associated with the greater than or equal to 7 score (second screening level). We propose this clinical score as a criterion for the indication of fecal cultures in children with acute gastroenteritis.
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PMID:[Validity of a score of clinical parameters as a screening method in acute bacterial diarrhea in childhood]. 212 97

Identification of infants with bacterial diarrhea during the first year of life is important to limit potentially serious complications, but indications for stool leukocyte examination and culture are not well defined. The ability of three clinical features--temperature, history of blood in the stool, and stool frequency--to predict the presence of bacterial gastroenteritis was analyzed. Over a 1-year period, 108 (10.4%) bacterial pathogens were isolated from 1,035 infants aged less than 1 year with diarrhea. Bacterial culture was positive in 14.9% of cases from May to October, compared with 6.2% of cases from November to April. A history of blood in the stool was the best individual predictor with sensitivity of 39%, specificity of 88%, and a positive predictive value of 30%. Temperature greater than 39 degrees C had sensitivity of 34% and specificity of 85%; greater than or equal to 10 stools in 24 hours had sensitivity of 28% and specificity of 85%. Using combinations of factors, we identified (1) a group of patients at high risk for bacterial diarrhea (infants with two of the three factors studied); (2) a low-risk group (those with temperature less than or equal to 38 degrees C, less than 10 stools in 24 hours, and the absence of blood in the stool); and (3) a group at intermediate risk for bacterial diarrhea (all other patients). We recommend routine stool cultures for infants with a high-risk combination. Additional clinical and laboratory features, such as stool leukocytes, should be studied among patients in the intermediate-risk group.
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PMID:Common clinical features as predictors of bacterial diarrhea in infants. 275 12

Incidence of rotavirus in children under 2 years of age, admitted to 2 children's hospitals i n Ankara, Turkey, from July 1984-June 1985 was measured using viral RNA electrophoresis in agarose gels. 375 children were selected at random from over 14,000 diarrhea admissions, and their stool specimens taken on admission were compared to those of 333 children without diarrhea. 61 (16.3%) of the diarrhea cases had detectable rotavirus, compared to 0% in controls. Bacteriologic tests for salmonella, Shigella and Campylobacter jejuni were positive for 51 (13.6%) of the diarrhea patients and 1.8% of controls. 1 child had both rotavirus and Salmonella. Rotavirus infection was highest in November- March, peaking in December. Bacterial diarrhea was prevalent in the summer. This pattern is typical of a temperate climate, although in developed countries bacterial gastroenteritis is not as prevalent. Since there are about 2340 diarrhea admissions annually for rotavirus in Ankara, from a population of 2,700,000, rotavirus vaccination seems appropriate.
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PMID:Rotaviruses in infants with diarrhea studied by viral RNA electrophoresis in Ankara, Turkey. 285 86

In studies conducted in seven countries, 392 persons with acute diarrhea were enrolled and randomly assigned to one of three regimens. In order to compare the effectiveness of various therapies for acute gastroenteritis, patients were treated for five days with either norfloxacin, 400 mg twice daily, norfloxacin, 400 mg three times a day, or trimethoprim/sulfamethoxazole, (160 mg/800 mg) twice daily. Clinical cure occurred in 89 percent (lower dose) and 91 percent (higher dose) of those treated with norfloxacin, compared with 78 percent of those receiving trimethoprim/sulfamethoxazole; cure rates in each treatment group were greater when the patient's stool contained fecal leukocytes. In 105 of 106 (99 percent) patients treated with either dose of norfloxacin and in 49 of 52 (94 percent) trimethoprim/sulfamethoxazole-treated subjects, the bacterial enteropathogen identified in the pretreatment stool was eradicated on the posttreatment specimen. Two percent (two patients) of those receiving the lower dose of norfloxacin, 3 percent (two patients) of those receiving trimethoprim/sulfamethoxazole, and 4 percent (three patients) of those receiving the higher dose of norfloxacin experienced minor and transient adverse hematologic or blood chemistry reactions. In addition, mild cutaneous reactions that were attributed to the study medications developed in two patients receiving the higher dose of norfloxacin and in three patients who received trimethoprim/sulfamethoxazole. These studies indicate that norfloxacin is safe and effective therapy for bacterial diarrhea.
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PMID:Use of norfloxacin in the treatment of acute diarrheal disease. 330 Mar 16

Stools from acute diarrhoea were investigated for bacterial and viral pathogens. In one study involving 63 young children in a paediatric ward, 70% of the stools were positive for the pathogens looked for of which 37% contained bacteria, 22% viruses and 11% mixed cultures of bacteria and viruses. In another study in which 130 watery stools from routine specimens of patients of all ages were investigated, 36% were positive for pathogens with 11% bacteria, 18% viruses and 7% mixed pathogens. The high incidence of bacterial diarrhoea in young children was attributed to gastroenteritis caused by Salmonella species. Salmonella and rotavirus were found the most common pathogens in bacterial and viral diarrhoeas, and the most susceptible age group was under 5 years-old.
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PMID:Aetiology of diarrhoea in Singapore. 332 52

A clinical study was undertaken using honey in oral rehydration solution in infants and children with gastroenteritis. The aim was to evaluate the influence of honey on the duration of acute diarrhoea and its value as a glucose substitute in oral rehydration. The results showed that honey shortens the duration of bacterial diarrhoea, does not prolong the duration of non-bacterial diarrhoea, and may safely be used as a substitute for glucose in an oral rehydration solution containing electrolytes. The correct dilution of honey, as well as the presence of electrolytes in the oral rehydration solution, however, must be maintained.
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PMID:Honey in the treatment of infantile gastroenteritis. 392 86

The purpose of this study is to identify the factors which are responsible for the delayed recovery in acute gastroenteritis (GE) in children. 372 children admitted to the University Department of Paediatrics were reviewed. 29 children (7.8%) required prolonged hospitalisation because of diarrhoea (delayed recovery group) and 343 children (92.2%) had short hospitalisation (normal recovery group). There was no significant difference in terms of race, sex, duration of symptoms before admission and severity of dehydration between the two groups. However, those with delayed recovery were significantly younger (mean age 14.4 months) than the normal recovery group (mean age 23.3 months). In the delayed recovery group, 32% were due to bacterial diarrhoea compared to 5.0% in the normal recovery group (p less than 0.05). The body weight of 31% of the delayed recovery group was less than the 3rd percentile (p less than 0.05). It is concluded that children take a longer time to recover from the bacterial GE than from non-bacterial GE. The younger children will take a longer time to recover from an episode of diarrhoea. The body weight also plays an important role in recovery, reflecting the importance of nutrition in the process of recovery.
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PMID:Delayed recovery following acute gastroenteritis in children. 408 97


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